Provider Demographics
NPI:1740765239
Name:MACHADO FLEITES, RAYSA MARIA (CBHCM)
Entity type:Individual
Prefix:
First Name:RAYSA
Middle Name:MARIA
Last Name:MACHADO FLEITES
Suffix:
Gender:F
Credentials:CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2204
Mailing Address - Country:US
Mailing Address - Phone:305-796-1231
Mailing Address - Fax:
Practice Address - Street 1:4750 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2204
Practice Address - Country:US
Practice Address - Phone:305-796-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH23337101YM0800X
FL221700000X
FLCBHCM.0103196171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist